Effect of an extruded pea or rice diet on postprandial insulin and cardiovascular responses in dogs.

Peas are increasing in popularity as a source of carbohydrate, protein and fibre in extruded canine diets. The aim of this study was to test the health effects of two canine diets with identical macronutrient profiles, but containing either yellow field peas or white rice as the carbohydrate source on metabolism, cardiovascular outcomes and adiposity. First, the acute glycemic, insulinemic and cardiovascular responses to the pea- or rice-based diets were determined in normal weight beagles (n = 7 dogs). The glycemic index did not differ between the pea diet (56 ± 12) and rice diet (63 ± 9). Next, obese beagles (n = 9) were fed the yellow field pea diet or white rice diet ad libitum for 12 weeks in a crossover study. Adiposity (measured using computed tomography), metabolic (oral glucose tolerance test, plasma leptin, adiponectin, C-reactive protein) and cardiovascular assessments (echocardiography and blood pressure) were performed before and after each crossover study period. After 12 weeks on each diet, peak insulin (p = 0.05) and area under the curve (AUC) for insulin after a 10 g oral glucose tolerance test (p = 0.05) were lower with the pea than the rice diet. Diet did not show a significant effect on body weight, fat distribution, cardiovascular variables, adiponectin or leptin. In conclusion, a diet containing yellow field peas reduced the postprandial insulin response after glucose challenge in dogs despite continued obesity, indicating improved metabolic health.

Hybrid Parallelism for Volume Rendering on Large-, Multi-, and Many-Core Systems.

With the computing industry trending toward multi- and many-core processors, we study how a standard visualization algorithm, raycasting volume rendering, can benefit from a hybrid parallelism approach. Hybrid parallelism provides the best of both worlds: using distributed-memory parallelism across a large numbers of nodes increases available FLOPs and memory, while exploiting shared-memory parallelism among the cores within each node ensures that each node performs its portion of the larger calculation as efficiently as possible. We demonstrate results from weak and strong scaling studies, at levels of concurrency ranging up to 216,000, and with data sets as large as 12.2 trillion cells. The greatest benefit from hybrid parallelism lies in the communication portion of the algorithm, the dominant cost at higher levels of concurrency. We show that reducing the number of participants with a hybrid approach significantly improves performance.

Visualization at supercomputing centers: the tale of little big iron and the three skinny guys.

Supercomputing centers are unique resources that aim to enable scientific knowledge discovery by employing large computational resources-the "Big Iron." Design, acquisition, installation, and management of the Big Iron are carefully planned and monitored. Because these Big Iron systems produce a tsunami of data, it's natural to colocate the visualization and analysis infrastructure. This infrastructure consists of hardware (Little Iron) and staff (Skinny Guys). Our collective experience suggests that design, acquisition, installation, and management of the Little Iron and Skinny Guys doesn't receive the same level of treatment as that of the Big Iron. This article explores the following questions about the Little Iron: How should we size the Little Iron to adequately support visualization and analysis of data coming off the Big Iron? What sort of capabilities must it have? Related questions concern the size of visualization support staff: How big should a visualization program be-that is, how many Skinny Guys should it have? What should the staff do? How much of the visualization should be provided as a support service, and how much should applications scientists be expected to do on their own?

A prospective evaluation of the timing of postoperative radiotherapy for preventing heterotopic ossification following traumatic acetabular fractures.

PURPOSE: Preoperative and immediate postoperative irradiation of traumatic acetabular fractures (TAF), although known to reduce heterotopic ossification (HO), can cause significant organizational and logistic difficulties. We sought to determine an acceptable time interval between surgery and radiation without compromising control, as well as to update our large experience and to further validate our treatment philosophy. METHODS AND MATERIALS: Beginning in June 1995, we began a prospective study, irradiating 152 patients on postoperative days 1, 2, or 3. There were also 17 patients delayed further secondary to medical difficulties. RESULTS: All patients treated since June 1995 received 700 cGy/1 fx. Fifty-eight patients received radiation within 24 hours of surgery, 41 within 2 days, 53 within 3 days, 13 within 4 days, and 4 were delayed further. Delaying irradiation for up to 4 days postoperatively caused no statistical increase in HO (p = 0.625). Of 263 patients in our retrospective cohort, HO occurred in 5.3% of patients who received irradiation versus 60% of patients who did not. CONCLUSION: In our prospective study, we noted no perceptible increase in HO with up to a 3-day interval between surgery and radiotherapy. This allows a more structured treatment schedule and allows the patient more time to heal and recover. Updated results from our overall series continue to demonstrate that adjuvant radiation decreases the incidence and severity of HO after TAF.

A phase I study of combined UFT plus leucovorin and radiotherapy for pancreatic cancer.

PURPOSE: This Phase I study combines tegafur and uracil (UFT) with leucovorin and conventional radiation for the treatment of pancreatic cancer. The design seeks to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLT) of this regimen as well as to define a future Phase II dose level. METHODS: Patients with locally advanced and unresectable pancreatic cancer were treated with 45 Gy of radiation therapy. The initial UFT dose was 150 mg/m(2)/day given with leucovorin 90 mg/day, both divided into 3 daily doses for 35 days concurrent with radiation. UFT doses were escalated at increments of 50 mg/m(2)/day. Dose-limiting toxicity (DLT) was defined as Grade 3 or greater nausea, vomiting or diarrhea despite medical intervention; or Grade 3 or greater neutropenia/thrombocytopenia; or Grade 3 or greater hepatic toxicity; or inability of the patient to take 75% or more of the planned UFT/leucovorin; or radiotherapy interruption of greater than 1 week. The MTD for UFT/leucovorin was exceeded by one dose level when a certain dose caused DLT in 2 or more patients of 6. RESULTS: Five evaluable patients had Stage I resectable disease but had pathologic adenopathy. Seven had Stage II unresectable disease. Compliance with therapy was excellent. At a daily dose of 300 mg/m(2) of UFT, we noticed minimal diarrhea and hematologic toxicity with mild-moderate nausea, anorexia, and fatigue. Three patients had Grade 4 toxicity: 1 had neutropenia on Day 38, 1 had diarrhea on Day 55, and 1 had vomiting on Day 15. CONCLUSION: Oral UFT/leucovorin and radiation therapy offers patients a viable treatment option for pancreatic cancer. The major known toxicity of diarrhea was tolerable. The MTD was not reached in this study. Our current plan is to expand this into a Phase I/II trial beginning at a UFT dose of 300 mg/m(2) and correlate this with clinical pharmacologic parameters. The potential benefit of long bioavailability and oral delivery of UFT compares favorably with continuous infusion regimens without the added morbidity of a catheter and pump.

Young and middle-aged adults' perceptions of elder abuse.

Middle-aged and young adults (ns = 201 and 422, respectively) completed an adaptation of the Severity of Violence Against Women Scale and the Elder Abuse Attitudes and Behavioral Intentions Scale--Revised to examine the impact of (a) respondent age, (b) age and gender of perpetrator and victim, and (c) history of experienced violence on perceptions of elder abuse. Results suggested that middle-aged respondents viewed psychological behaviors more harshly than did younger respondents and that both middle-aged women and young men were less tolerant of middle-aged perpetrators. Although history of participatory violence toward older persons was predictive of perceptions of elder abuse as it interacted with respondent age, history of experienced abuse was not predictive. These data support a view of elder abuse that emphasizes its relativistic nature, wherein perceptions of elder abuse depend on both the characteristics of the perceiver and the victim and perpetrator variables.

Radiation response of Rosai-Dorfman disease presenting with involvement of the orbits.

The purpose of this study was to review an interesting case of recurrent orbital sinus histiocytosis. The patient initially failed surgery, chemotherapy, and steroid therapy, only to have a durable response to low-dose radiation therapy of the orbits, lasting 6 and 11 years, respectively. Because there are few documented responses to radiotherapy, we present a case report in conjunction with the clinical, radiographic, and histopathologic information as well as a literature review of similar cases.

Phase I/IIa study of concurrent paclitaxel and cisplatin with radiation therapy in locally advanced non-small cell lung cancer: analysis of early and late pulmonary morbidity.

Recent efforts to improve survival outcome in patients with locally advanced non-small cell lung cancer have focused on the use of chemoradiotherapy regimens containing vinblastine/cisplatin or etoposide/cisplatin. However, the overall treatment outcome with these regimens remains poor, emphasizing the need for new therapeutic options. Based on the activity of paclitaxel in advanced non-small cell lung cancer, its additive cytotoxicity with cisplatin, and the radiation-sensitizing effect of both agents, a phase I/IIa study was designed to examine the feasibility of paclitaxel/cisplatin concurrently with conventional thoracic irradiation in patients with locally advanced tumors. One major concern regarding combined modality therapy has been the enhancement of pulmonary toxicity. This report describes the incidence and severity of pulmonary toxicities observed in this trial according to the Radiation Therapy Oncology Group scoring criteria. A literature-based review was performed in an attempt to determine the impact of paclitaxel-based versus non-paclitaxel-based chemoradiotherapy regimens on the early and late pulmonary morbidity. Twenty-four evaluable patients died and 14 (37%) are still alive without evidence of disease. The 1- and 2-year survival rates are 62% and 40%, respectively, with a median survival of 17 months. Pulmonary toxicity >/=grade 2 was more frequently manifested as late toxicity in approximately 70% of the patients. In most, prompt symptomatic and radiologic improvement was observed with the early administration of corticosteroids. There were three late grade 5 toxicities characterized by diffuse (bilateral) rapidly progressive interstitial infiltrates. Protracted lymphocytopenia was noted in the great majority of patients, and its role in the pathogenesis of this complication remains to be determined. There were minor changes in pulmonary function parameters, except in the forced vital capacity and diffusion capacity to carbon monoxide. In a univariate analysis, no relationship was noted between paclitaxel dose level, degree of lymphocytopenia, changes in pulmonary function indices, and incidence of pulmonary toxicity. However, there was a significant dose-volume relationship (using conventional dose-volume histograms) with late pulmonary toxicity at radiation doses between 15 Gy and 30 Gy. Based on a literature review, paclitaxel-based chemotherapy regimens seem to be associated with a slightly higher risk of pulmonary toxicity; however, comparison of such toxicity between trials has many limitations that require that the conclusion reached be viewed with caution.

Performance of healthy adults versus individuals with brain injuries on the supplemental measures of the WAIS-R NI.

The Wechsler Adult Intelligence Scale-Revised as a Neuropsychological Instrument (WAIS-R NI) provides methods to uniformly interpret atypical responses or response patterns. To date, little research has examined the primary population for which the supplemental measures of the WAIS-R NI were intended. The purpose of the present study was to compare the performance of individuals with brain injuries versus healthy adults on the supplemental measures of the WAIS-R NI. Forty-nine healthy adults and 45 individuals with brain injuries were tested. MANOVA indicated a significant main effect for group membership and the results suggest the WAIS-R NI supplemental measures differentiate individuals with brain injuries from healthy adults.

Accuracy of diagnosis of persistent vegetative state.

We reviewed pre-admission diagnosis in all patients referred for inpatient brain injury neurorehabilitation over a 5-year period (n = 193). All patients more than 1 month postinjury with diagnosis of coma or persistent vegetative state were selected for review (n = 49). We found that 18 (37%) of these patients were diagnosed inaccurately. Inaccurate diagnosis was more likely if the injury was more than 3 months before admission and the etiology of injury was trauma (48%). Results were statistically significant when traumatic injuries were compared with anoxic injuries (p < 0.10). Errors in diagnosis may result from confusion in terminology, lack of extended observation of patients, and lack of skill or training in the assessment of neurologically devastated patients.

A national survey of nebuliser use.

Nebuliser drug delivery units were reused in 15% of paediatric wards participating in a national survey, while routine servicing and written information was provided by only half the wards issuing home nebulisers. Written information should be developed as a national resource, and further research on optimal cleaning practices is required.

Psychological stress and the passage of a standard meal through the stomach and small intestine in man.

Gastric emptying half-time and mouth to caecum transit time of a solid meal were measured in eight normal volunteers, once during a period of psychological stress and again during a period of relative calm. No consistent or significant effect on gastric emptying was observed, but mouth to caecum transit times were faster in all subjects and this difference was highly significant (p<0.01).

Provocative testing for coronary arterial spasm: rationale, risk and clinical illustrations.

Two cases of Prinzmetal's variant angina are presented in which coronary spasm was documented by electrocardiographic evidence obtained in the coronary care unit during provocative testing with ergonovine maleate after the arteriographic demonstration of anatomically normal coronary arteries. The rationale and risks of provocative testing for spasm in patients with chest pain and anatomically normal coronary arteries are reviewed. The advantages of performing provocative testing in the coronary care unit after arteriography rather than in the catheterization laboratory during coronary arteriography are discussed.